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Pathology of the Head and Neck Antonio Cardesa · Pieter J Antonio Cardesa · Pieter J. Slootweg (Eds.) Pathology of the Head and Neck Antonio Cardesa · Pieter J. Slootweg (Eds.) Pathology of the Head and Neck With 249 Figures in 308 separate Illustrations and 17 Tables 123 Professor Dr. Antonio Cardesa Department of Pathological Anatomy Hospital Clinic University of Barcelona Villarroel 170 08036 Barcelona Spain Professor Pieter J. Slootweg Department of Pathology University Medical Center St. Radboud P.O. Box 9101 6500 HB Nijmegen The Netherlands Library of Congress Control Number: 2006922731 ISBN-10 3-540-30628-5 Springer Berlin Heidelberg New York ISBN-13 978-3-540-30628-3 Springer Berlin Heidelberg New York This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other way and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under German Copyright Law. Springer is a part of Springer Science+Business Media springer.com © Springer-Verlag Berlin Heidelberg 2006 Printed in Germany The use of general descriptive names, trademarks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and thereof free for general use. Product liability: the publishers cannot guarantee the accuracy of any information about dosage and applica- tion contained in this book. In every individual case the user must check such information by consulting the relevant literature. Editor: Gabriele Schröder, Heidelberg Desk Editor: Ellen Blasig, Heidelberg Production: LE-TEX, Jelonek, Schmidt & Vöckler GbR, Leipzig Typesetting: Satz-Druck-Service, Leimen Cover: Frido Steinen-Broo, eStudio Calamar, Spain Printed on acid-free paper 24/3100/YL 5 4 3 2 1 0 To Gerhard Seifert and to Leslie Michaels, great pioneers of Head and Neck Pathology in Europe and founding members of the Working Group on Head and Neck Pathology of the European Society of Pathology. Foreword Pathology of the Head and Neck is an easy sounding pathology of the head and neck that remain an unex- title for a complex subject matter. This title stands for an plored world. Examples include the never-ending prob- accumulation of diverse diseases occurring in different lem of prognostication of tumour diseases, the patho- organs whose relationship to each other consists in the genetic significance of tumour precursor lesions and fact that they are located between the base of the skull the validation of appropriate sets of tumour markers as and the thoracic aperture. One reason for assembling meaningful predictors of malignancy. all these different organs under the title “Pathology of The editors of the book, Professor Antonio Carde- the Head and Neck” is that the proximity of the organs sa and Professor Pieter Slootweg, are leading experts in of the head and neck region makes it difficult for the the field of the pathology of the head and neck. As such surgical pathologist to focus on one of these organs and they are the main members of the Working Group on neglect the pathology of others, which are only a centi- Pathology of the Head and Neck of the European Society metre apart. A second reason, however, is that the upper of Pathology, one of the first European working groups digestive tract and the upper respiratory tract, which to be founded under the auspices of the European Soci- meet in the larynx, have some basic diseases in com- ety of Pathology. In this multi-author book the exper- mon, notably squamous cell carcinoma. Thus pathology tise of outstanding experts on the pathology of the head of the head and neck is both an arbitrary compilation of and neck in Europe is reflected. The chapters are char- diseases and, at least to some extent, a group of disease acterised by the desire to correlate pathology with all entities with a common morphological and pathoge- necessary information on clinical features, epidemiolo- netic trunk. gy, pathogenesis and molecular genetics. The authors of The past years have seen remarkable advances in these chapters have not attempted to be encyclopaedic, many fields of pathology, including that of the head and but rather have aimed at providing concise, yet adequate neck. There is a need for a book that integrates surgical knowledge. They are therefore to be warmly commend- pathology with molecular genetics, epidemiology, clin- ed for providing us with an excellent book, which will ical behaviour and biology. This book provides a com- prove useful to surgical pathologists involved in the pa- prehensive description of the manifold aspects of the thology of the head and neck. morphology and pathology of the organs of the head and neck region. These description, as comprehensive as Kiel, Germany Günter Klöppel they may be, also show that there are some areas of the March 2006 Contents IX Preface This book was initially conceived as a unitary group of adnexa. The pathology of the thyroid and parathyroid chapters on “Pathology of the Head and Neck”, to be glands and lymph nodes is covered in greater detail published in German within the series of volumes of elsewhere. Remmele’s Textbook of Pathology. From the outset, the Since the authors selected for writing the different editorial approach was to concentrate on pathological chapters are international experts and members of the entities that are either unique to or quite characteristic of Working Group on Head and Neck Pathology of the the head and neck. At the same time, we strove to avoid European Society of Pathology, the chief editors of the as much as possible unnecessary details on systemic series, Prof. Wolfgang Remmele, Prof. Hans Kreipe and diseases that, although involving the head and neck Prof. Günter Klöppel, accepted that all manuscripts region, have their main focus of activity in other organs. should be in English. After the original texts had been Thus, “Pathology of the Head and Neck” encompasses submitted, it became clear to the editors and publisher the wide range of diseases encountered in the complex that, in addition to their translation to fit into Remme- anatomic region extending proximally from the frontal le’s Textbook, the work warranted publication in English sinuses, orbits, roof of the sphenoidal sinuses and clivus as a separate book. Therefore, we want to thank the chief to distally the upper borders of the sternal manubrium, editors and the publisher Springer for their stimulating clavicles and first ribs. This includes the eyes, ears , upper support and trust. We add our special thanks to the au- aerodigestive tract, salivary glands, dental apparatus, thors who produced such an excellent work, as well as to thyroid and parathyroid glands, as well as all the those secretaries, photographers and others who helped epithelial, fibrous, fatty, muscular, vascular, lymphoid, them. cartilaginous, osseous and neural tissues or structures Finally, we should like to express our wish that this related to them. book on “Pathology of the Head and Neck”, the first The contents have been divided into ten chapters. The ever written as a joint project by a Working Group of the first covers the spectrum of precursor and neoplastic European Society of Pathology, could serve as an example lesions of the squamous epithelium. It is followed by for new books written by other Working Groups. chapters devoted to the nasal cavities and paranasal sinuses, oral cavity, maxillofacial skeleton and teeth, Barcelona, Spain Prof. Antonio Cardesa salivary glands, nasopharynx and Waldeyer`s ring, larynx and hypopharynx, ear and temporal bone, Nijmegen, The Netherlands Prof. Pieter J. Slootweg neck and neck dissection, as well as eye and ocular March 2006 Contents 1 Benign and Potentially Malignant 1.3.2.4 Invasive Front . 15 Lesions of the Squamous Epithelium 1.3.2.5 Stromal Reaction . 15 and Squamous Cell Carcinoma . 1 N. Gale, N. Zidar 1.3.2.6 Diff erential Diagnosis . 15 1.3.2.7 Treatment and Prognosis . 15 1.1 Squamous Cell Papilloma 1.3.3 Spindle Cell Carcinoma . 16 and Related Lesions . 2 1.3.3.1 Aetiology . 16 1.1.1 Squamous Cell Papilloma, Verruca Vulgaris, 1.3.3.2 Pathologic Features . 16 Condyloma Acuminatum 1.3.3.3 Diff erential Diagnosis . 17 and Focal Epithelial Hyperplasia . 2 1.3.3.4 Treatment and Prognosis . 17 1.1.2 Laryngeal Papillomatosis . 3 1.3.4 Verrucous Carcinoma . 17 1.3.4.1 Aetiology . 17 1.2 Squamous Intraepithelial Lesions (SILS) 4 1.3.4.2 Pathologic Features . 18 1.2.1 General Considerations . 4 1.3.4.3 Diff erential Diagnosis . 18 1.2.2 Terminological Problems . 4 1.3.4.4 Treatment . 18 1.2.3 Aetiology . 5 1.3.4.5 Prognosis . 19 1.2.3.1 Oral Cavity and Oropharyn . 5 1.3.5 Papillary Squamous Cell Carcinoma . 19 1.2.3.2 Larynx . 5 1.3.5.1 Aetiology . 19 1.2.4 Clinical Features 1.3.5.2 Pathologic Features . 19 and Macroscopic Appearances . 6 1.3.5.3 Diff erential Diagnosis . 20 1.2.4.1 Oral and Oropharyngeal Leukoplakia, 1.3.5.4 Treatment and Prognosis . 20 Proliferative Verrucous Leukoplakia 1.3.6 Basaloid Squamous Cell Carcinoma . 20 and Erythroplakia . 6 1.3.6.1 Aetiology . 20 1.2.4.2 Laryngeal and Hypopharyngeal 1.3.6.2 Pathologic Features . 20 Leukoplakia and Chronic Laryngitis . 7 1.3.6.3 Diff erential Diagnosis .
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